LONG-TERM PREDICTIVE VALUE OF BLEEDING ON PROBING IN PERI‑IMPLANTITIS DIAGNOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Objective

This systematic review and meta-analysis aimed to evaluate the diagnostic value of bleeding on probing (BOP) for peri‑implantitis detection on implant- and patient-levels, as reported in prospective and retrospective studies with at least 5 years of follow-up.

Materials and Methods

A systematic search of 3 electronic databases was conducted and supplemented with a hand-search to identify clinical studies that reported the prevalence of peri‑implantitis and BOP after at least 5 years of functional loading. Random-effects meta-analyses were conducted to combine the proportions of peri‑implantitis among BOP positive implants and patients across studies. Heterogeneity was explored with subgroup analyses.

Results

5826 patients and 17,198 implants were included in this review. Definitions of peri‑implantitis varied between studies. Thirty studies were included for assessment. Implant-level meta-analysis was conducted in 24 studies and patient-level meta-analysis in 19 studies. Overall proportion of peri‑implantitis in BOP-positive implants was 26.5% (95% CI, 21.2 to 32.1) and 35.1% (95% CI, 27.4 to 43.1) in BOP-positive patients. Substantial heterogeneity was present, and prediction intervals were 5.2%-56% and 6.4%-71.5% at the implant- and patient-level, respectively.

Conclusion

Within the limitations, prevalence of peri‑implantitis was found to be around 1 third in both BOP-positive implants and patients. Prevalence varied between studies. Although a guiding clinical factor in the diagnosis of peri‑implantitis, clinicians should be aware of the significant false-positive rates of BOP.